Single forearm radius and ulna asymmetric lengthening in multiple cartilaginous exostoses

Massobrio, M; Antonietti, Giorgio; Pellicanò, Giovanni Francesco; Necci, Fabiana

doi:10.1097/bpb.0000000000000212

Cited by 3 publications

(9 citation statements)

References 18 publications

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“…The literature extraction process involved 4 phases: (a) identification, (b) screening, (c) eligibility, and (d) inclusion. There were only three prospective case series studies [ 20 , 27 , 39 ] (OCEBM type II) versus 31 retrospective studies (OCEBM type III). These prospective studies had small sample sizes [ 39 ] or were simply case reports [ 20 , 27 ].…”

Section: Resultsmentioning

confidence: 99%

“…There were only three prospective case series studies [ 20 , 27 , 39 ] (OCEBM type II) versus 31 retrospective studies (OCEBM type III). These prospective studies had small sample sizes [ 39 ] or were simply case reports [ 20 , 27 ]. The characteristics of the 34 final studies included in this systematic review are presented in ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Unbalanced physeal growth between the radius and ulna can result in forearm bowing, relative shortening of radius or ulna, carpal instability, and radial head dislocation with subsequent limitation of forearm rotation [ 1 , 4 ]. Forearm HMO has been managed by one or more of the following procedures isolated excision of osteochondroma [ 6 – 12 ], acute [ 7 , 12 , 13 ], and/or gradual [ 6 , 14 – 26 ] ulnar lengthening, combined ulnar and radial lengthening [ 27 ], distal radial hemiepiphysiodesis [ 3 , 12 , 28 , 29 ], corrective radial osteotomy [ 7 , 13 , 30 ], creation of one-bone forearm [ 31 – 33 ], radial head relocation [ 8 , 10 , 22 ], reconstruction of the distal ulnar epiphysis by vascularized proximal fibula epiphysis [ 34 ] and Sauve-Kapandji procedure [ 10 ]. Nevertheless, the optimal management of HMO of the forearm is greatly disputable.…”

Section: Introductionmentioning

confidence: 99%

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Current paediatric orthopaedic practice in hereditary multiple osteochondromas of the forearm: a systematic review

El-Sobky

Samir

Atiyya

et al. 2018

SICOT-J

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Introduction: This systematic review aims to answer three research questions concerning the management of hereditary multiple osteochondromas of forearm in children: What is the best available evidence for the currently employed surgical procedures? What patient characteristics are associated with better prognosis? What disease characteristics are associated with better prognosis?Methods: We searched the literature using three major databases with no publication date restrictions. To enhance search sensitivity and maintain precision we used keywords/subject terms correlating with patient population, problem and interventions. We used strict inclusion/exclusion criteria to improve validity evidence.Results: The search process yielded 34 eligible studies with a total of 282 patients (315 forearms). We comprehensively analysed study and patient demographics and interventions and outcomes. Eleven studies (32%) had a long-term follow-up and 31 studies (91%) were retrospective. Of the total number of forearms, ulnar lengthening +/− associated procedures was used in 210 forearms (66.7%), isolated osteochondroma excision in 65 forearms (20.6%) and isolated distal radius hemiepiphysiodesis in 15 forearms (4.7%) among others.Discussion: Ulnar lengthening can restore radiologic anatomy, improve appearance and to a lesser extent objective clinical parameters like joint range of motion on the short/intermediate term. Isolated osteochondroma excision can relief pain and satisfy cosmetic concerns occasionally. There is poor evidence to suggest that surgery improves quality of life or function. Predictors of surgical success in regard to patient and disease characteristics remain elusive. Natural history and prospective randomized control studies where the control group receives no treatment should be rethought. They have the potential for bias control and identification of the ideal surgical candidate. The complex interplay between the confounding variables has undermined the capability of most studies to provide well-grounded evidence to support and generalize their conclusions. Valid quality of life scales should supplement objective outcome measures.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Current paediatric orthopaedic practice in hereditary multiple osteochondromas of the forearm: a systematic review

El-Sobky

Samir

Atiyya

et al. 2018

SICOT-J

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“…Most of the authors opine that the indication for deformity correction in MHO is ulna shortening by 1.5 cm or radius shortening by more than 60 %, increase in RAA more than 30°, radial head instability and restrictions of motion in the wrist and elbow joints [6,16]. Ulna shortening averaged 14 mm in our patients that had types I и IVА of the deformities, and in type IVВ it was up to 24.5 ± 11.9 mm [26][27][28][29][30].…”

Section: Discussionmentioning

confidence: 76%

“…So, N.D. Clement and D.E. Porter stated that the magnitude of ulna shortening relative to the radius and the radial head dislocation are the risk factors of rotation limitation of the forearm bones and note the need of early surgical interventions in children [26][27][28].…”

Section: Discussionmentioning

confidence: 99%

Clinical and radiological characteristics of forearm deformities in children with multiple hereditary exostoses

Zakharyan¹,

Белоусова²,

Pozdeev³

2019

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Introduction The incidence of forearm deformities in children with multiple hereditary exostoses (MHE) ranges from 30 to 80 %. There are few studies of deformities of the forearm in MHE patients in the literature that describe not only the location of exostoses and position of the head of the radius but also the true variants of forearm deformities. The aim of the study was to investigate forearm bone deformities in patients with multiple hereditary exostoses. Materials and methods Radiographs of the bones of the forearm in 84 patients (151 limbs) diagnosed with multiple hereditary exostoses in the age of four to 17 years who were treated at our institute from 2004 to 2018 were retrospectively analysed. The study involved 47 boys and 37 girls; 67 patients (80 %) had bilateral lesions, and 17 patients (20 %) had lesions of only one upper limb. Patients were divided into four groups depending on the type according to the Jo& Jung's classification. The deformities were evaluated based on radiological methods in accordance with the reference lines and angles for the forearm bones. Results The most common variants of forearm deformities were revealed: varus recurvatum at the border of the upper and middle third of the ulna (55 %), varus recurvatum at the border of the upper and middle third of the ulna associated with varus of the radius in the middle third (15 % of cases); as well as their combinations accompanied by dislocation or subluxation of the radial head (30 %). RAA (radial articular angle) and RB (radial bowing) did not have significant difference in various types of deformities of the forearm according to Jo&Jung's classification. Conclusion The study of the variety of forearm deformities in children due to multiple hereditary exostoses will assist in a differentiated approach to the choice of surgical treatment methods depending on the type of deformity.

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A Commentary on “Clinical and Functional Outcomes of Ulnar Lengthening in the Treatment of Masada Type I Forearm Deformities in Hereditary Multiple Osteochondromas”

Moharrami

Arabi

2020

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Single forearm radius and ulna asymmetric lengthening in multiple cartilaginous exostoses

Cited by 3 publications

References 18 publications

Current paediatric orthopaedic practice in hereditary multiple osteochondromas of the forearm: a systematic review

Current paediatric orthopaedic practice in hereditary multiple osteochondromas of the forearm: a systematic review

Clinical and radiological characteristics of forearm deformities in children with multiple hereditary exostoses

A Commentary on “Clinical and Functional Outcomes of Ulnar Lengthening in the Treatment of Masada Type I Forearm Deformities in Hereditary Multiple Osteochondromas”

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